Some Causes and Features of Vaginal Bleeding During Early Pregnancy
Cause |
Common Features* |
Tests† |
Pregnancy-related (obstetric) disorders |
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An ectopic pregnancy (an abnormally located pregnancy—not in its usual place in the uterus) |
Sometimes only slight vaginal bleeding Abdominal or pelvic pain that Usually tenderness when the pelvic examination is done If the ectopic pregnancy has ruptured, fainting, light-headedness, or a racing heart |
Usually blood tests to measure a hormone produced by the placenta (human chorionic gonadotropin, or hCG) Ultrasonography of the pelvis Sometimes laparoscopy (insertion of a viewing tube through an incision in the abdomen) or laparotomy (surgery involving an incision into the abdomen) |
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A miscarriage that |
Crampy pain in the pelvis and often throughout the abdomen Often vaginal bleeding, sometimes with passage of tissue from the fetus |
Tests as for ectopic pregnancy |
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Septic abortion (infection of the contents of the uterus) |
Fever and chills, constant abdominal pain, vaginal discharge that contains pus Usually in women who have had an intentional abortion (often done by untrained practitioners or by the women themselves) |
Tests as for ectopic pregnancy Cultures of samples taken from the cervix |
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A hydatidiform mole (overgrowth of tissue from the placenta) or another form of gestational trophoblastic disease |
A uterus that is larger than expected No heartbeat or movement detected in the fetus Sometimes high blood pressure, swelling of the feet or hands, severe vomiting, or passage of tissue that resembles a bunch of grapes |
Tests as for ectopic pregnancy |
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Rupture of a corpus luteum cyst (which develops in the structure that releases the egg after the egg is released) |
Abdominal or pelvic pain that Most common during the first 12 weeks of pregnancy |
Tests as for ectopic pregnancy |
Disorders unrelated to the pregnancy |
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Vaginitis (inflammation of the vagina, often due to infection) |
Only spotting or slight bleeding A vaginal discharge Sometimes pain during sexual intercourse, pelvic pain, or both |
A doctor’s examination to rule out other causes Cultures of samples taken from the cervix |
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Cervicitis (infection of the cervix) |
Only spotting or slight bleeding Sometimes tenderness when the pelvic examination is done, abdominal pain, or both |
A doctor’s examination to rule out other causes Cultures of samples taken from the cervix |
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Polyps (fingerlike growths) in the cervix, which are usually benign |
Slight bleeding No pain Polyps sometimes seen protruding from cervix |
A doctor’s examination Follow-up visits to further evaluate the polyps |
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Injury |
A tear in the cervix or vagina Possibly due to a procedure such a amniocentesis |
A doctor's examination |
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*Features include symptoms and results of the doctor's examination. Features mentioned are typical but not always present. |
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†A urine pregnancy test is typically done if women have had only a home pregnancy test. Because an ectopic pregnancy can be very dangerous, tests are done to look for ectopic pregnancy in most pregnant women with vaginal bleeding unless symptoms clearly point to another disorder. |
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